Department of Cardiovascular, Thoracic and Paediatric Surgery, Faculty of Medicine, Yamagata University, Yamagata, Japan.
Department of Cardiovascular, Thoracic and Paediatric Surgery, Faculty of Medicine, Yamagata University, Yamagata, Japan.
Heart Lung Circ. 2020 Nov;29(11):e273-e275. doi: 10.1016/j.hlc.2020.07.002. Epub 2020 Jul 28.
In the currently evolving field of endovascular surgery, most brachiocephalic aneurysms are treated with stent grafts. Connective tissue disorders are considered a relative contraindication for endovascular repair because of the risk of adverse events at the landing zone in the aorta and its branches, although the surgical grafts from previous repairs could provide stable landing zones. We attempted a new hybrid operative technique for a brachiocephalic aneurysm in a patient with Loeys-Dietz syndrome, who was unsuitable for open surgery because of multiple previous surgeries and possible lung malignancy. The operation was performed by creating an appropriate landing zone using a prosthetic graft followed by endovascular stent grafting, which yielded good results. This hybrid operation is expected to expand the potential for endovascular treatment in patients with connective tissue diseases who are deemed unsuitable for open surgery.
在目前不断发展的血管内外科学领域，大多数头臂动脉瘤采用支架移植物进行治疗。结缔组织疾病被认为是血管内修复的相对禁忌症，因为在主动脉及其分支的着陆区有发生不良事件的风险，尽管先前修复的外科移植物可提供稳定的着陆区。我们尝试了一种新的杂交手术技术，用于治疗患有洛伊兹-迪茨综合征的头臂动脉瘤患者，由于多次先前的手术和可能的肺癌，该患者不适合进行开放性手术。该手术通过使用假体移植物创建合适的着陆区，然后进行血管内支架移植物置入来完成，取得了良好的效果。这种杂交手术有望为那些被认为不适合开放性手术的结缔组织疾病患者扩大血管内治疗的潜力。
